Ogilvie Syndrome Medication

  • Author: Prospere Remy, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Jan 5, 2012
 

Medication Summary

Prior to medical therapy, a mechanical bowel obstruction must be excluded. Ensure that colonic air is found in all colonic segments, including the rectosigmoid, prior to consideration of neostigmine therapy.[6] If air is not demonstrable on abdominal films, a mechanical obstruction should be excluded via contrast enema.

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Acetylcholinesterase Inhibitors

Class Summary

Ponec et al demonstrated the utility of neostigmine in colonic pseudo-obstruction.[7]

In a small study examining the effects of pyridostigmine on colonic motility disorders, O'Dea et al investigated treatment outcomes in 6 patients with slow-transit constipation and 7 patients with recurrent pseudo-obstruction of the bowel.[8] The authors found some symptom improvement in all of the patients suffering from pseudo-obstruction, with few side effects occurring (although 2 patients later underwent surgery for recurrent symptoms). However, pyridostigmine did not reduce symptoms in those patients with slow-transit constipation.

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Neostigmine (Prostigmin)

 

Inhibits destruction of acetylcholine by acetylcholinesterase, which facilitates transmission of impulses across myoneural junction.

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Enema Therapies

Class Summary

These agents can be helpful in some circumstances. This therapy may cleanse the colon and gently enhance colonic motility, thereby correcting the underlying problem. The cleansing effect may also make subsequent attempts at colonoscopic decompression easier.

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Polyethylene glycol (GoLYTELY)

 

Laxative with strong electrolyte and osmotic effects that has cathartic actions in GI tract.

Tap water enema

 

Lubricates the bowel and softens the stool. Can be used as a retention enema.

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Contributor Information and Disclosures
Author

Prospere Remy, MD  Assistant Professor of Medicine, Albert Einstein College of Medicine; Attending Physician, Department of Internal Medicine, Bronx-Lebanon Hospital Center

Prospere Remy, MD is a member of the following medical societies: American College of Physicians and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Coauthor(s)

Kavitha Kumbum, MD  Associate Program Director and Attending Physician, Gastroenterology Fellowship Program, Division of Gastroenterology, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine

Kavitha Kumbum, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, and New York Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Steven Lee Carpenter, MD, FACP, AGAF, FASGE  Academic Chair, Associate Professor of Medicine, Department of Internal Medicine, Internal Medicine Program Director, Mercer University School of Medicine; Senior Partner, The Center for Digestive and Liver Health, The Endoscopy Center

Steven Lee Carpenter, MD, FACP, AGAF, FASGE is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Bjorn Holmstrom, MD  Assistant Professor, Department of Internal Medicine, University of South Florida

Bjorn Holmstrom, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American Medical Association, Medical Association of Georgia, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Douglas M Heuman, MD, FACP, FACG, AGAF  Chief of GI, Hepatology, and Nutrition at North Shore University Hospital/Long Island Jewish Medical Center; Professor, Department of Medicine, Hofstra North Shore-LIJ School of Medicine

Douglas M Heuman, MD, FACP, FACG, AGAF is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Physicians, and American Gastroenterological Association

Disclosure: Novartis Grant/research funds Other; Bayer Grant/research funds Other; Otsuka Grant/research funds None; Bristol Myers Squibb Grant/research funds Other; Scynexis None None; Salix Grant/research funds Other; MannKind Other

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

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